older adults Flashcards
components of functional domain
function
nutrition
vision
hearing
safety and mobility assessment
performance-oriented mobility assessment
tinoetti balance and gait evaluation
ASPEN malnutrition definition
2 of the following:
insufficient energy intake
loss of muscle mass
weight loss
loss of SQ fat
diminished functional status (handgrip strength)
localized or generalized fluid accumulation
recommended vision screening
q 1-2 years
psychologic domain assesments
cognitive assessment
affective assessment (depression screening tool)
average life expectancy
78.79
causes for underreporting illness
ageism
perception of unresponsive system for care (this is a normal thing of aging)
depression
dementia
denial (fear of consequences)
body systems most often affected by age-related decline
neuro
CV
musculoskeleteal
lower urinary
most common symptoms of illness
acute confusion
depression
falls
incontinence
syncope
why are older adults vulnerable to geriatric syndromes?
decreased physiologic reserve
delirium first line treatment
haldiol 0.5-1 mg BID
check QTc!
2nd line delirium treatment options
olanzapine 2.5 mg BID
quetiapine 25 mg BID
risperidone 0.5 mg BID
lorazepam 0.5-1 mg q4h
trazodone 25-150 mg QHS
agitation treatment
haldol
risperidone
biggest risk factor for fall
previous fall
causes of transient incontinence
DIAPPERS
delirium
infection
atrophic uretitis and vaginitis
pharmaceuticals
psychological factors
excess urinary output
restricted mobility
stool impaction
established risk factors for incontinence
older age
female
increased BMI
dementia
DM
limited physical activity
types of incontinence
urethral incompetence (stress)
detrusor overactivity (urge)
functional
high post void residual
detrusor under activity (overflow)
mixed
incontinence workup
history
focused physical
UA with C/S
PVR
consider: BMP, renal US, urologic evaluation, urodynamic testing
management for urethral (stress) incompetence
kegels, limit fluid and caffeine, bladder suspension
management for detrusor overactivity/urge
bladder training, bladder relaxants (oxybutinin)
management for functional incontinence
environmental manipulations, undergarments/pads, behavioral interventions
management of high PVR
removal of obstruction, consider intermittent cath, long-term cath
management of detrusor underactivity/overflow incontinence
bladder decompression with intermittent or indwelling Cath followed by initiation of alpha blocking agents (tamsulosin)
finasteride if enlarged prostate
1 modifiable risk factor for falls
> 4 medications
acute dizziness
<2 months
chronic dizziness
> 2 months